Comparison of the effectiveness of biofeedback-assisted pelvic floor muscle training and hypopressive exercises in women with pelvic organ prolapse: a randomized controlled study

Objective. The aim of this randomized controlled study was to examine the effectiveness of biofeedback-assisted pel­vic floor muscle training (PFMT) and hypopressive exer­cises (HE) in women with pelvic organ prolapse (POP). Metho­do­logy. Thirty-two women diagnosed with POP (stages 2 and 3) according to the POP Classification System were in­clu­ded in the study. The participants were randomly as­signed to three groups: the PFMT group (n=10), the HE group (n=12), and the control group (n=10). To ensure that the participants performed the exercises correctly, they re­ceived three sessions of biofeedback-assisted PFMT/HE trai­ning. The exercises were performed as a home program for 12 weeks. All participants were given recommendations re­gar­ding POP. The Pelvic Organ Prolapse Symptom Score, the Pelvic Floor Distress Inventory-20, pelvic floor muscle strength assessment (using a perineometer), and quality of life assessment (using a Visual Analog Scale [VAS]) were ap­plied. Compliance with the 12-week exercise program was also assessed using VAS. Results. Compared to baseline and the control group, both PFMT and HE groups showed a reduction in POP symptoms, an increase in pelvic floor mus­cle strength, and an improvement in the quality of life after 12 weeks of treatment (p<0.05). There was no sta­tis­ti­cally significant difference between the exercise groups in post-treatment assessments (p>0.05). Exercise ad­he­rence was similar between the PFMT and HE groups (p>0.05). Conclusions. Pelvic floor muscle training and hypo­pres­sive exercises, when taught with biofeedback, were found to be effective in reducing POP symptoms. Teaching the exercises with biofeedback may have contributed to the patients’ correct understanding and execution of the exer­cises, thereby improving adherence. Further studies are needed to investigate the long-term effectiveness of exercise ap­proaches and to develop patient-specific strategies to en­hance compliance.